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在医疗单位开展老年人护理教育并应用于实践的可行性:护士的看法及实践环境的影响。

The feasibility of implementing education on older person care to practice on medical units: Nurses' perceptions and the influence of practice context.

作者信息

Hunter Kathleen F, Dahlke Sherry, Negrin Kelly, Kalogirou Maya Reshef, Fox Mary, Antonio Natasha, Buckborough Neena, Morgan Angela, Wagg Adrian

机构信息

Faculty of Nursing, University of Alberta, Edmonton, AB, Canada.

York University, Toronto, ON, Canada.

出版信息

Int J Older People Nurs. 2019 Dec;14(4):e12265. doi: 10.1111/opn.12265. Epub 2019 Aug 22.

Abstract

AIM

As part of a larger primary study on evidence-informed practice with hospitalised older people, we aimed to (a) examine nursing staffs' perceptions of the interactive geriatric educational intervention and to explore how perceptions of their work context may influence their ability to enact the evidence-informed assessment and care approaches discussed during the educational sessions and (b) compare differences in perceptions of context between RNs, LPNs and HCAs.

METHOD

A survey-based evaluation that used both closed and open-ended questions was conducted as part of an interactive educational intervention on cognitive impairment and managing responsive behaviours. Data were gathered on participants' perceptions of the education intervention and organisational context.

RESULTS

Findings from this study suggest when education is tailored to nurses' articulated educational needs, it is well received; however, barriers to implementation exist. Assessment of the context by using a standardised survey tool to get the nursing staffs' perceptions of organisational context revealed strengths in leadership support and day-to-day interactions with other nurses and healthcare professionals, but potential barriers related to lack of facilitation to transfer new knowledge into practice existed.

CONCLUSION

Providing evidence-based education related to care of older patients and evaluating nursing staffs' perceptions of the education and their context has laid the groundwork for a long-term relationship with the managers and nursing staff on the participating medical units. Further investigation about how best to incorporate the facilitator role into the medical units to support evidence-based practices with older patients is warranted.  IMPLICATIONS FOR PRACTICE: While nurses are receptive to new knowledge, the unpredictable workload of acute care creates challenges to implementing this new knowledge. Assessment of contextual factors that influence evidence-informed practice facilitates planning for implementation of new knowledge and support practice change.

摘要

目的

作为一项关于住院老年人循证实践的大型初步研究的一部分,我们旨在:(a) 考察护理人员对交互式老年教育干预的看法,并探讨他们对工作环境的看法如何可能影响他们在教育课程中讨论的循证评估和护理方法的实施能力;(b) 比较注册护士(RN)、执照职业护士(LPN)和医疗护理助理(HCA)对环境看法的差异。

方法

作为一项关于认知障碍和应对行为管理的交互式教育干预的一部分,进行了一项基于调查的评估,该评估使用了封闭式和开放式问题。收集了参与者对教育干预和组织环境的看法的数据。

结果

本研究结果表明,当教育针对护士明确提出的教育需求进行调整时,会受到好评;然而,实施存在障碍。通过使用标准化调查工具评估环境以获取护理人员对组织环境的看法,结果显示在领导支持以及与其他护士和医疗保健专业人员的日常互动方面存在优势,但也存在与缺乏促进将新知识转化为实践相关的潜在障碍。

结论

提供与老年患者护理相关的循证教育,并评估护理人员对教育及其环境的看法,为与参与医疗单位的管理人员和护理人员建立长期关系奠定了基础。有必要进一步研究如何最好地将促进者角色纳入医疗单位,以支持针对老年患者的循证实践。对实践的启示:虽然护士愿意接受新知识,但急性护理中不可预测的工作量给实施这些新知识带来了挑战。评估影响循证实践的背景因素有助于规划新知识的实施并支持实践变革。

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